The broad, long term objective of this project is to extend our understanding of neuro-vascular relationships in the pediatric fovea, the area in the central retina that mediates the exquisite acuity in the healthy, mature eye. Neural and vascular elements participate in the development of the normal fovea both pre- and post-natally, and pediatric retinal disorders can alter the neuro-vascular relations during development. To test hypotheses about the fovea, our group of eight investigators requests an ultra-high resolution multimodal adaptive optics retinal imager ("PSI Retinal Imager"). This instrument enables non-invasive, in vivo acquisition of images of retinal cross-sections with nearly the same fidelity as traditional histological sections. It provides images showing nuclear, plexiform, and photoreceptor layers as well as en-face images of vasculature and neurons side-by-side at selected retinal depths. With current NIH funding, the major users investigate the eyes in pediatric subjects with a history of preterm birth (Fulton, VanderVeen, Leviton) and refractive errors in a primate model (Troilo). It is well established that retinopathy of prematurity (ROP), and even premature birth alone, alters the neural and vascular elements of the retina, but there is much more to learn about the photoreceptors and the perifoveal vasculature in subjects born preterm. The minor users'research broadens our understanding of the retina. Although the rat does not have a fovea, rat models of ROP provide an opportunity to examine the fundamental biology of neuro-vascular pathologies (Hansen). Collaborations with Genetics (Irons) and Otorhinolaryngology (Kenna) are designed to investigate the foveas in genotyped subjects with heritable conditions including albinism, Stargardt juvenile macular degeneration, and Usher syndrome which, like preterm birth and ROP, cause visual deficits in childhood. Incorporating the eye tracker into the PSI Retinal Imager is necessary for acquiring uncorrupted images from the latter subjects, as well as those with ROP who have nystagmus and/or unsteady fixation. Myopia and other significant refractive errors are common in subjects with these disorders. Thus, studies of the fovea in healthy individuals with myopia provide critical reference data against which data from subjects with retinal pathologies may be compared (Coletta). The PSI Retinal Imager will allow us to obtain quantitative information that will provide new insights into the neuro-vascular components of foveal disorders. We believe that this new knowledge will lead to better management of pediatric retina patients. PUBLIC HEALTH RELEVANCE: Investigators of retinal disorders request an ultra-high resolution Retinal Imager (Physical Sciences Inc.) for further studies of the fine structure of the pediatric fovea and neurovascular relations in the central retina. Their objectives are to gain new knowledge and insights into the basis for childhood blindness and visual loss caused by disorders affecting the central retina. New understanding will contribute to plans for improved care and treatment.